A Note from Christine
Big changes are happening in the Medicare Program that also
deal with estate planning!
Just recently, Medicare approved an initiative to pay local doctors to have
conversations with their patients regarding their healthcare and end-of-life
Medicare is hoping this new “push” will get more people
talking openly about the type of care they do, or do not want, in a medical
crisis with their physicians.
The reasons are both practical and financial; many people go on to
receive treatments that they would would NEVER want to at the end of
their life because they failed to complete a Living Will or make
their wishes known to their family.
By having such healthcare conversations in the doctor’s office, then,
Medicare is hoping to cut back on unnecessary services, and also empower
families to know that they will be able to do everything their loved one
“would have wanted” during an illness, disability or incapacity.
Of course as an estate planning attorney, I’m excited about this
initiative to get patients and their doctors talking and on the same page.
However, it’s important to remember that doctors can not give
legal advice, so taking the leap from making your wishes KNOWN to
making them legally binding will still fall on the
patient and his or her attorney to complete that last step.
I’ve included some important conversation starters in the
feature article below to help you get these discussions flowing with your
doctor. And, when you’re clear on your goals and wishes for
medical, long-term or end-of-life care, call the office and we’ll
schedule a time for you to come into complete legally binding Powers of
Attorneys and Advanced Healthcare Directives.
Have a great month,
Medicare Wants You to Talk to Your Doctor About Medical
and End-Of-Life Wishes
Medicare is hoping to encourage more patients to talk to
their doctors about end-of-life preferences and wishes for medical care by now
paying physicians to have these critical conversations during office visits.
In an effort to incentivize more physicians to have open conversations with
their patients about medical and end-of-life wishes, Medicare will now pay
doctors to talk about healthcare directives during office visits.
The logic behind the decision, according to Medicare, is simple; studies show
that patients are more satisfied and receive better quality care when Advance
Healthcare Directives that lay out a patient's wishes for care are available
and legally in place.
A recent survey of emergency room physicians by Geneia confirms this idea,
Most emergency medicine physicians (93 percent) are less frustrated in cases
where an advance directive is easily accessible.
Eighty-five percent of emergency medicine physicians agree, "When a patient
says they have an advance directive, it helps me deliver better quality of
Nearly nine in 10 emergency medicine physicians believe family members are more
satisfied with the medical care when patients' wishes are known and
communicated in an advance directive.
More than half (54 percent) of emergency medicine physicians describe their
reaction to learning a patient has an accessible advance directive in place as
The other factor, according to Medicare, is purely financial. End-of-life care
is complicated and expensive.
Many people at the end of their life go on to endure treatment that they would
likely not agree to, if given the choice. By documenting a person's true
end-of-life wishes and setting out clear boundaries for when life-saving
measures such as feeding tubes or ventilators are to stop, Medicare hopes to
cut back on non-beneficial medical interventions in advanced illness.
It's important to remember that Advanced Healthcare Directives are actually
legal documents and physicians are unable to give legal advice; but having
conversations about medical and long-term care with a doctor is a great place
to start in exploring end-of-life options and making your wishes known.
For example, if you are dealing with a specific illness (such as cancer), your
doctor would be able to lay out the normal course of treatment that you could
expect over the following months and years. If there is something you do not
agree with, or do not want, this is a great time to begin drawing boundaries
around your care with your doctor.
The issue of incapacity is another topic to bring up in the doctor's office. In
addition to legally naming someone in a Healthcare Directive who can make
decisions if you are unable to speak for yourself, your doctor may also want
you to complete a HIPAA form to keep on file listing this person as well. This
will help direct your doctor as to who he or she should (or should not)
communicate with if something happens to you.
Additional medical and end-of-life wishes to explore with your doctor include:
Whom do you trust to make make medical decisions on your behalf?
How do you feel about feeding tubes, life support and other artificial life
What about organ donation?
Is there any type of medical care you would NEVER want?
If you were permanently disabled or incapacitated, what things would contribute
or take away from your "quality of life"?
What are your thoughts on nursing home vs. in-home health care?
Under the new Medicare provisions, physicians will get paid in 30 minute
increments for discussing these topics with their patients.
But, to ensure all the bases covered, be sure to take the final step to have
Healthcare Directives and Powers of Attorneys created with the help of an
attorney so you'll have the peace of mind knowing that the issues discussed
with your doctor are properly documented and will be legally honored later.
Need Assistance Reaching Your Financial
Then you may want to connect with my friend and financial
planner, Michael Haymond. Michael enjoys the sense of accomplishment he gets
helping others simplify their financial lives while assisting them in reaching
their goals. To achieve that, Michael seeks to build lasting relationships
based on trust and knowledge. Michael believes it is possible to help clients
achieve their financial objectives using planning techniques and tools that
have been honed over two decades of managing money through tough economic
conditions. By understanding the client's objectives and risk tolerance,
Michael works to provide his client's with a plan of action designed to meet
their goals while minimizing their risk exposure.
You can learn more about Michael and his services at: http://www.ehgfinancial.com/team/michael-haymond
About Christine Brown
Christine received her bachelor's degree from U.C. Santa Barbara and
is a 1992 graduate of the University of the
McGeorge School of Law.
She is formerly a partner in the law firm of
Lebetsamer & Brown, LLP.
In January 2002, she opened her own law firm
concentrates solely in the
area of elder law. Her special emphasis is on
long-term care planning
and the concerns of the elderly, while also
in estate planning, trust administration,
Christine is a member of the National
Law Attorneys (NAELA),
the South Bay Bar Probate and Estate
well as other
community organizations concerned with the
adults. As an active
member of her community and State Bar,
various Superior Court Probate Departments
public with legal
issues. She works regularly with California
Nursing Home Reform
("CANHR") and the Los Angeles Caregiver
here to learn more >>